Why screen newborns for cocaine

Service patterns and social outcomes at age one year

Robert S. Byrd, Allyson M. Neistadt, Cynthia R. Howard, Carol Brownstein-Evans, Michael Weitzman

    Research output: Contribution to journalArticle

    Abstract

    Objective: To compare baseline characteristics, service provision, and child placement for infants exposed to cocaine in utero based on postnatal screening results. Methods: We studied a retrospective cohort of 40 consecutive drug-exposed, but seemingly healthy term infants who underwent urine drug screening in the newborn nursery of a community hospital. Using clinical and service agency data, two cocaine-exposed cohorts were compared (a) screen-positive at birth (n = 22) versus (b) screen-negative at birth (n = 18). Results: Both cocaine-exposed groups had similar infant birth weights, levels of paternal involvement, maternal ages, gravidity, parity, and lengths of gestation. Mothers in both groups had similar histories of prostitution, poor home environment, drug use, and prenatal drug rehabilitation. Mothers of screen-positive infants were more likely than mothers of screen-negative infants to have other children in foster care (27% vs. 6%, p = .07), to have experienced previous interventions by child protective services (CPS) (55% vs. 17%, p < .01), to have had no prenatal care (32% vs. 6%, p = .09), and fewer prenatal visits (4.7 vs. 8.6, p = .02). Compared to screen-negative infants, more screen-positive infants were referred to a high-risk infant tracking program (91% vs. 6%), referred to CPS (100% vs. 33%), placed outside the mother's home (50% vs. 22%), and had their mothers referred to drug rehabilitation (36% vs. 11%), (p < .01 for each). By 1 year of age, support services differed little between exposed cohorts. However, 6 of 22 screen- positive infants were in foster care and 3 were placed for adoption, while only 1 of the 18 screen-negative infants was in foster care and only I had been placed for adoption. There were no services available in this community to provide coordinated or comprehensive services or drug treatment specific to the needs of drug using mothers and drug exposed infants. Conclusions: Despite similarities between cocaine-exposed infants cared for in a normal newborn setting (with and without positive urine drug screens at birth), differences in referral services were noted. More striking than these differences was that services for families with drug-exposed infants are inadequate to even meet the needs of those families in our setting deemed to be at highest risk. Neonatal drug screening needs to be paired with effective services.

    Original languageEnglish (US)
    Pages (from-to)523-530
    Number of pages8
    JournalChild Abuse and Neglect
    Volume23
    Issue number6
    DOIs
    StatePublished - Jun 1 1999

    Fingerprint

    Social Work
    Cocaine
    Newborn Infant
    Mothers
    Pharmaceutical Preparations
    Preclinical Drug Evaluations
    Parturition
    Rehabilitation
    Urine
    Sex Work
    Gravidity
    Neonatal Screening
    Prenatal Care
    Nurseries
    Community Hospital
    Maternal Age
    Parity
    Birth Weight
    Referral and Consultation

    Keywords

    • High-risk families
    • Prenatal cocaine exposure

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Developmental and Educational Psychology
    • Psychiatry and Mental health

    Cite this

    Byrd, R. S., Neistadt, A. M., Howard, C. R., Brownstein-Evans, C., & Weitzman, M. (1999). Why screen newborns for cocaine: Service patterns and social outcomes at age one year. Child Abuse and Neglect, 23(6), 523-530. https://doi.org/10.1016/S0145-2134(99)00031-9

    Why screen newborns for cocaine : Service patterns and social outcomes at age one year. / Byrd, Robert S.; Neistadt, Allyson M.; Howard, Cynthia R.; Brownstein-Evans, Carol; Weitzman, Michael.

    In: Child Abuse and Neglect, Vol. 23, No. 6, 01.06.1999, p. 523-530.

    Research output: Contribution to journalArticle

    Byrd, RS, Neistadt, AM, Howard, CR, Brownstein-Evans, C & Weitzman, M 1999, 'Why screen newborns for cocaine: Service patterns and social outcomes at age one year', Child Abuse and Neglect, vol. 23, no. 6, pp. 523-530. https://doi.org/10.1016/S0145-2134(99)00031-9
    Byrd, Robert S. ; Neistadt, Allyson M. ; Howard, Cynthia R. ; Brownstein-Evans, Carol ; Weitzman, Michael. / Why screen newborns for cocaine : Service patterns and social outcomes at age one year. In: Child Abuse and Neglect. 1999 ; Vol. 23, No. 6. pp. 523-530.
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